Summary
Background
Nocturnal Enuresis (NE) is considered as a multifactorial condition with a specific
focus on psychological functioning regarding etiology. Various studies show that children
with NE suffer from different types of self-esteem problems and insecure attachment
styles. Nevertheless the relationship between these two psychological functions has
not been adequately studied.
Objective
Main objective of the current study is to evaluate self-perception and attachment
profiles of enuretic children in relation with various sociodemographic parameters.
Design
41 children with nocturnal enuresis and 40 age and sex matched healthy controls were
compared in means of attachment using Kern's Security Scale and self-perception using
Self-Perception Profile for Children measures.
Results
Our results show that enuretic children suffer significantly more insecure attachment
styles and negative self perception issues. Moreover enuretic children varied from
healthy controls in means of number of siblings and birth rank.
Discussion
Current study suggests that enuretic children should be evaluated for possible psychological
difficulties like insecure attachment and self-esteem issues and proper interventions
in these areas should be considered. Lower self-esteem as a well-known phenomenon
in enuresis research may be addressed in relation with insecure attachment. Nevertheless
our study have certain limitation; the possible psychiatric comorbidities from both
study groups were excluded only with anamneses. Further the male dominance of the
gender of the participants can be seen as a limitation.
Conclusion

Graphical AbstractImportant findings from the current study at a glance.
Keywords
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References
- The standardization of terminology of lower urinary tract function in children and adolescents: update report from the standardization committee of the International Children's Continence Society.Neurourol Urodyn. 2016; 35: 471-481https://doi.org/10.1002/nau.22751
- Management and treatment of nocturnal enuresis—an updated standardization document from the International Children's Continence Society.J Pediatr Urol. 2020; 16: 10-19https://doi.org/10.1016/j.jpurol.2019.12.020
- Prevalence of nocturnal enuresis and its influence on quality of life in school-aged children.J Pediatr Urol. 2016; 12: 159.e1-159.e6https://doi.org/10.1016/J.JPUROL.2015.11.011
- Psychological correlates of enuresis: a case-control study on an Italian sample.Pediatr Nephrol. 2011; 26: 1829-1836https://doi.org/10.1007/s00467-011-1880-3
- Impact of nocturnal enuresis on children and young people.Scand J Urol Nephrol. 2001; 35: 169-176https://doi.org/10.1080/003655901750291908
- More anxious or more shy? Examining the social anxiety levels of adolescents with primary enuresis nocturna: a controlled study.J Pediatr Urol. 2019; 15: 343.e1-343.e5https://doi.org/10.1016/j.jpurol.2019.04.002
- The relation between attachment and depression in children and adolescents: a multilevel meta-analysis.Clin Child Fam Psychol Rev. 2020; 23: 54-69https://doi.org/10.1007/s10567-019-00299-9
- The impact of monosymptomatic nocturnal enuresis on attachment parameters.Scand J Urol Nephrol. 2004; 38: 47-52https://doi.org/10.1080/00365590310001665
- Nocturnal enuresis impaired children's quality of life and friendships.Acta Paediatr Int J Paediatr. 2017; 106: 806-811https://doi.org/10.1111/apa.13787
- Self-esteem in children with nocturnal enuresis and urinary incontinence: improvement of self-esteem after treatment.in: European Urology. Karger Publishers, 1998: 16-19https://doi.org/10.1159/000052236
- Does primary nocturnal enuresis affect childrens' self-esteem?.J Fam Pract. 2015; 64: 250-259https://go.gale.com/ps/i.do?p=AONE&sw=w&issn=00943509&v=2.1&it=r&id=GALE%7CA411470780&sid=googleScholar&linkaccess=fulltextDate accessed: October 10, 2021
- An investigation of the impact of nocturnal enuresis on children's self-concept.Scand J Urol Nephrol. 2002; 36: 204-208https://doi.org/10.1080/003655902320131884
- Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs.Front Psychol. 2013; 4: 863https://doi.org/10.3389/FPSYG.2013.00863/ABSTRACT
- Peer relationships and preadolescents' perceptions of security in the child-mother relationship.Dev Psychol. 1996; 32: 457-466
- Orta çocukluk döneminde ebeveynlere bağlanma, benlik algısı ve kaygı. [Attachment to parents during middle childhood, self-perceptions, and anxiety.Türk Psikol Derg. 2009; 24: 86-101
- The perceived competence scale for children.Child Dev. 1982; 53: 87-97https://doi.org/10.2307/1129640
- Çocuklar için benlik algısı profilinin uyarlanması ve farklı değişkenlere göre ölçme değişmezliğinin test edilmesi.Elem Educ Online. 2017; 16: 1425-1450https://doi.org/10.17051/ILKONLINE.2017.342965
- Enuresis, early attachment and intimacy.Br J Psychother. 1998; 15: 167-176https://doi.org/10.1111/j.1752-0118.1998.tb00440.x
- The prediction of social problem-solving skills based on birth order and attachment styles.Adv Appl Sociol. 2014; 4: 15-19https://doi.org/10.4236/AASOCI.2014.41003
- How birth order moderates the negative effects of insecure attachment on anticipatory anxiety regarding parent care.Curr Psychol. 2021; 1 (2021): 1-7https://doi.org/10.1007/S12144-021-02314-1
- Analysing effects of birth order on intelligence, educational attainment, big five and risk aversion in an Indonesian sample.2020: 234-248https://doi.org/10.1002/PER.2285
- Healthy(?), wealthy, and wise: birth order and adult health.Econ Hum Biol. 2016; 23: 27-45https://doi.org/10.1016/J.EHB.2016.06.005
- A study of students' loneliness levels and their attachment styles.Artic J Educ Train Stud. 2017; 5https://doi.org/10.11114/jets.v5i7.2395
- Personality symptoms and self-esteem as correlates of psychopathology in child psychiatric patients: evaluating multiple informant data.Child Psychiatr Hum Dev. 2009; 40 (40 (2009)): 499-515https://doi.org/10.1007/S10578-009-0140-2
- Adherence in children with nocturnal enuresis.J Pediatr Urol. 2009; 5: 105-109https://doi.org/10.1016/J.JPUROL.2008.10.002
- Self-image and performance in children with nocturnal enuresis.Eur Urol. 2002; 41: 660-667https://doi.org/10.1016/S0302-2838(02)00127-6
- Self-esteem in 6- to 16-year-olds with monosymptomatic nocturnal enuresis.J Paediatr Child Health. 2012; 10: E178-E182https://doi.org/10.1111/J.1440-1754.2012.02577.X
- Comorbid psychiatric disorders in children and adolescents with nocturnal enuresis.Urol J. 2017; 14: 2968-2972https://doi.org/10.22037/uj.v14i1.3635
Article info
Publication history
Published online: October 12, 2022
Accepted:
October 6,
2022
Received in revised form:
September 26,
2022
Received:
April 12,
2022
Identification
Copyright
© 2022 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.